Lead Referral and Surgical Coordinator

Retina Consultants, Ltd. is a medical and surgical retina practice providing unmatched care to the Chicagoland area for over 35 years.

The Lead Referral and Surgical Coordinator is responsible for overseeing the coordination of patient referrals, insurance verification, and surgical scheduling processes. This role ensures the efficient handling of pre- and post-operative procedures, patient communication, and insurance authorization. The coordinator serves as a key liaison between patients, healthcare providers, and insurance companies while maintaining compliance with all healthcare regulations and organizational policies.

Essential Duties and Responsibilities

• Confirm and validate patient insurance coverage by contacting insurance companies via phone, online portals, or other designated methods.
• Gather and document accurate patient information, including demographics and insurance policy specifics.
• Conduct patient interviews and provide pre-operative counseling, including discussion of medical history, required pre-operative testing, and pre- and post-operative care instructions.
• Communicate clearly with patients regarding insurance coverage, benefits, and potential out-of-pocket expenses.
• Collaborate with healthcare providers to obtain and update necessary information related to patient insurance and surgical scheduling.
• Initiate and manage pre-authorizations for procedures and request office visit referrals.
• Identify and resolve discrepancies or issues with insurance information, taking proactive steps to address challenges.
• Accurately record and maintain insurance and referral details in electronic health record (EHR) systems such as eClinicalWorks and Epic, as well as in billing and payer systems.
• Ensure compliance with all healthcare regulations, including HIPAA, when handling patient information.
• Establish and maintain positive relationships with insurance representatives and clinical partners to ensure efficient communication and resolution of issues.
• Develop and implement workflows and procedures to improve the efficiency and accuracy of referral and surgical coordination processes.
• Provide leadership and support to referral and scheduling staff to promote teamwork, accountability, and high performance.
• Demonstrate proactive, professional communication across and within departments to facilitate smooth workflow and represent the department positively throughout the organization.

Qualifications

• Education: High school diploma or equivalent required; Associate degree in healthcare administration or related field preferred.
• Experience:
• Previous patient contact or customer service experience required.
• Minimum of [insert number, e.g., 2–3] years of experience in medical referrals, insurance verification, or surgical coordination preferred.
• Experience with electronic medical records systems, specifically eClinicalWorks, Health Nautica, and Availity, required.
• Knowledge and Skills:
• Working knowledge of insurance verification, referrals, and pre-authorization processes.
• Basic understanding of CPT and ICD-10 coding.
• Strong written and verbal communication skills.
• Exceptional organizational skills with the ability to multitask and prioritize effectively.
• Strong critical thinking and problem-solving abilities.
• Ability to work independently and collaboratively within a team environment.
• Ability to remain calm and professional under pressure.Working Conditions
• Office or clinical setting with frequent patient and provider interaction.

Performance Expectations

• Maintain accuracy and timeliness in referrals, insurance verification, and surgical scheduling.
• Ensure compliance with HIPAA and organizational confidentiality standards.
• Demonstrate leadership, professionalism, and collaboration across all levels of the organization.
• Support process improvement initiatives that enhance patient experience and departmental efficiency.
• Requires use of computer systems, telephones, and electronic communication platforms.
• May require occasional extended hours based on departmental needs.

Job Type: Full-time

Pay: $23.00 - $24.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $23 - $24